Policy Resource

Kentucky Sobriety Treatment and Recovery Team (START) program for Parents Involved with the Child Welfare System

Feb 9, 2016

Kentucky is engaged in cross-system collaboration to meet the needs of young children with substance-abusing parents involved with the child welfare system.

The Kentucky Sobriety Treatment and Recovery Team (START) program uses an intensive intervention model that integrates addiction services, family preservation, community partnerships, and best practices in child welfare and substance abuse treatment. The program aims to reduce recurrence of child abuse and neglect, improve substance abuse disorder (SUD) treatment rates, build protective parenting capacities, and increase the countys and states capacity to address co-occurring substance abuse and child maltreatment. It was adapted in 2006 from the START model developed in Cleveland, Ohio.

START pairs specially trained child protective service (CPS) workers with family mentors, who have at least three years of sobriety and previous involvement with CPS, to work with families. The program also partners with substance abuse treatment providers to ensure START participants have quick access to intensive treatment. Decision-making is shared among all team members, including the family and court.

START is currently being implemented in 4 counties with a fifth under development. The program is directed and funded by the state CPS department (the Kentucky Department for Community Based Services) in partnership with local treatment providers and with consultation on early childhood mental health needs from the state behavioral health office (Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities).

As of December 2015, 806 families, including 1,423 adults and 1,643 children have been served by START. Data from 2013 showed the integrated program produced twice the rates of sobriety and less than half the rates of placement of children in state custody (20% or less, compared to 41%) than typical practice. Specifically, 66% of women and 40% of men achieved sobriety at closure of their child welfare case, including clean drug tests and progress in both CPS and SUD treatment, compared with a 37% favorable discharge rate overall for CPS-involved clients served in publicly funded SUD treatment programs. A recent cost analysis found that for every $1 spent on START, the state avoids $2.52 in the cost of foster care. START has also been successful in bringing much-needed support services to underserved areas, especially in rural Appalachia.

In early 2016, START was given a provisional scientific rating of 3 (Promising Research Evidence) and a provisional high rating for Child Welfare System Relevance Level through the California Evidence-Based Clearinghouse for Child Welfare. For more information on this rating, see http://www.cebc4cw.org/program/sobriety-treatment-and-recovery-teams/detailed

A report describing START as a state policy response is available at http://www.zerotothree.org/public-policy/federal-policy/childwelfareweb.pdf

Updated February 2016.

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